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Loss Of Appetite In The Elderly

senior lady looking sadly at her food

Your elderly parent or loved one skipped breakfast this morning, which was fine. But when lunchtime came, they turned that down too.

You’ve grown concerned, as this isn’t the first time they’ve missed meals. What causes appetite loss in the elderly?

Seniors can experience reduced appetite for many reasons, including:

  • Medication side effects
  • Chronic disease pain
  • Illness
  • Depression and other mental health issues
  • Social circumstance changes
  • Aging

This guide to the loss of appetite in the elderly will explain the physiological and psychological effects that can strip a senior of their appetite and what caregivers can do to encourage their older family members to eat a healthy diet. 

Is Loss Of Appetite Normal In The Elderly?

Appetite loss and refusal to eat is a regular and normal occurrence in many seniors.

According to a 2015 publication in the journal Nursing Older People, “Poor appetite is a common problem in older people living at home and in care homes, as well as hospital inpatients.”

The data suggests that it doesn’t matter how accessible food is to seniors.

Even if the older person doesn’t have to prepare it themselves (which can be difficult with age and decreased mobility), they still may not necessarily want to eat.

We’ll explain more about why that is in the next section. 

Occasionally foregoing meals or snacks is okay, but frequently skipping meals can be detrimental to a senior’s health.

As the Nursing Older People data states, “It [poor appetite] can contribute to weight loss and nutritional deficiencies, and associated poor healthcare outcomes, including increased mortality.” 

What Affects Appetite In The Elderly?

Why doesn’t your senior parent or loved one want to eat? Let’s explore the reasons we outlined in the intro.

Medication Side Effects

Look up the medications the senior takes online or check the label for side effects.

Opioids, hydralazine, fluoxetine, digoxin, amphetamines, antibiotics, and chemotherapy can reduce a person’s appetite, but that’s not an exhaustive list.

The first step is to check with their doctor to see if it is possible that their current medications are the underlying cause of their decreased food intake.

If it’s possible, perhaps your senior can reduce their dosage or switch to a different medication for possible appetite improvements.

However, that’s not always possible. In situations like that, appetite stimulants – which we’ll discuss in more detail later in this article – are advisable.

Chronic Disease Pain

Eating is low on your priority list when dealing with constant pain.

That can explain the appetite loss your senior parent or loved one experiences.

They might also struggle physically with chewing and swallowing, as these acts can exacerbate their pain. 

Medication for chronic pain might alleviate their eating woes and improve their quality of life.

However, medication can be a double-edged sword, with some eroding appetite even more. 

Illness

Feeling under the weather can take away one’s appetite, as can the medications a senior takes to feel better.

Depending on the duration and frequency, illnesses in the elderly can cause long-term appetite changes. 

Cognitive Changes

For elderly patients with dementia and Alzheimer’s disease, appetite changes can come about due to the changes the disease creates in their brains.

The Alzheimer’s Association reports that, “Regular, nutritious meals may become a challenge for people living in the middle and late stages of Alzheimer’s. They may become overwhelmed with too many food choices, forget to eat or think they have already eaten.

This was true for my friend’s mom who had Alzheimer’s. My friend would leave food in the refrigerator so her mom could get the proper nutrition while she was at work during the day.

But often her mom forgot to eat her breakfast and lunch and just ate one meal a day with my friend when she got home from work.

My friend solved the problem by hiring a part time caregiver to come in a make sure her mom ate, which helped restore a little bit of the body weight she’d lost before the problem was understood.

Mental Health Disorders

Major depressive disorder, anxiety disorder, and other mental health disorders can impact appetite (and the refusal to take care of oneself) in the elderly.

A depressed senior might spend hours or days in bed, skipping meals and foregoing activities and hobbies that used to bring them joy.

However, depression doesn’t always decrease appetite.

Some patients with major depressive disorder report no appetite changes, while others have an increased appetite.  

Social Circumstantial Changes

Eating is a very social act.

When stripping away the social element, as can happen when elderly individuals become isolated at home or in a facility, they might not find meal times as enjoyable as they once did. They might begin missing meals. 

Further, food aversions can develop, especially if a senior lived independently but no longer does.

Whether you prepare meals for them or an assisted living or nursing facility does, if the senior doesn’t like how the food tastes, they won’t eat. 

Aging Process

Even if your senior parent or loved one faces none of the above issues, old age can reduce their appetite . 

The aging process changes the digestive system, slowing down digestive functioning, so it takes longer for elderly adults to process their meals.

This can make it take longer for them to feel hungry again.

Further, hormonal changes and reduced senses – including the sense of taste and smell – reduce the joy of eating.

What To Do When An Elderly Person Has No Appetite

Understanding why your senior parent or loved one doesn’t want to eat is only half the battle.

The other half is getting them to ingest more food, but what should you do?

Here are some options to consider.

Switch To Drinkable Meals

Drinking one’s meals can still provide all the nutrients, vitamins, and minerals a senior needs, especially if you purchase drinkable meals formulated for seniors. 

Drinkable meals can be things like yogurt drinks, Boost, soups and broths, and protein shakes.

It’s easier for many seniors with chronic health issues to drink instead of chew, and they’ll stay hydrated as well, making drinkable meals doubly advantageous. 

My 97-year-old aunt prepares and eats 3 meals a day, but she consumes very small meals.

So she drinks Boost to supplement her calories and help her maintain weight (she’s tiny and loses weight easily).

Eat With The Elderly

If your senior parent’s struggles with eating center around their isolation and loneliness, begin visiting more regularly and sharing meals together. 

Or if you’re not nearby and they have the ability to do a video chat, try eating “with” them via video occasionally.

If they reside in a nursing home or assisted living facility, talk to the staff to ensure someone is around during the senior’s meal when you cannot be, whether it’s a fellow resident or staff member. 

Encourage Snacking

The elderly should ideally eat three meals a day but snacking in lieu of a smaller meal like lunch is okay on some days.

In these cases, the senior should eat healthy, filling, nutritious snacks such as fruits, vegetables, nuts, or seeds. 

Make Food More Flavorful

Does your senior’s issue with eating stem from flavorless food? Incorporate more taste with herbs and spices. 

However, use a light hand, as many seniors must watch their sodium. Other spices besides salt often contain sodium.

Herbs are a more healthful alternative, and you can season with them generously. 

Offer Easy-To-Eat Foods

Sometimes, encouraging more regular eating is as easy as making the food simpler to ingest.

Cut foods into bite-sized or finger-sized pieces, mash or puree tough foods, and introduce meals that don’t need utensils, as seniors might struggle to hold them or maintain their grip. 

Treat Dry Mouth

A dry mouth can make all but the wettest foods like fruits and veggies taste like sandpaper going down.

This can explain why your senior parent or loved one doesn’t want to eat or has developed a sudden food aversion.

Sucking on ice cubes, increasing hydration, and chewing sugar-free gum can help with dry mouth, as can artificial saliva products. 

Talk to your senior’s doctor if dry mouth becomes a chronic issue, as they might recommend an over the counter saliva stimulant.

If that doesn’t work, talk to their doctor and ask for a prescription saliva stimulant, like Evoxac (cevimeline) or Salagen (pilocarpine).

Lifestyle changes like using humidifiers can also lessen dry mouth severity.

Reduce Portion Size

The problem with a senior’s eating habits could be that the portions are too large.

Smaller meals can promote more eating but select nutrient-rich meals and sides so a senior doesn’t risk nutrient deficiencies.

Serve plenty of finger foods, too, in the form of healthy snacks such as soft cheeses, nut butter, olive oil, chopped cheeses, and avocado.  

Make Eating A Routine

Create a dining routine for your senior and their appetite may gradually return.

Eating on a schedule triggers the body to produce hunger and thirst signals around specific times.

For best results, keep up the schedule daily. 

Try An Appetite Stimulant

The last measure to consider is an appetite stimulant.

Speak with your senior’s doctor before beginning an appetite stimulant to ask for their recommendation.

The doctor might suggest trying the other methods above first or might move the senior straight to the stimulant. 

What Is The Best Appetite Stimulant For The Elderly?

The senior’s doctor may prescribe an appetite stimulant, including a starting dosage.

Each has side effects, and the doctor may recommend increasing or reducing the senior’s stimulant dosage to control symptoms while increasing appetite.

Here are some common appetite stimulants that can help older adults.  

Dronabinol 

This medication is commonly used for controlling vomiting and nausea from chemotherapy treatments when other medications haven’t worked, but it’s also regularly prescribed for lack of appetite. 

Dronabinol is a type of cannabinoid that’s administered as an oral liquid capsule. A senior will likely take it on an empty stomach a half-hour before they eat.

They can take later doses (as needed) after eating or before. 

The standard dosage of dronabinol to increase appetite is two doses a day, typically one hour before lunch and dinner. Drink at least six ounces of water with every dose. 

The possible side effects include:

  • Lightheadedness
  • Vision issues
  • Headaches
  • Unusual or strange thoughts
  • Depression
  • Hallucinations
  • Elevated mood, including feeling detached from your body
  • Dizziness and unsteadiness when walking
  • Concentration issues
  • Fatigue
  • Confusion
  • Anxiety
  • Memory loss
  • Nausea and stomach pain
  • Vomiting
  • Weakness 

Serious side effects that warrant immediate medical attention are fainting, fast heart rate, and seizures.

Mirtazapine

The antidepressant mirtazapine can increase appetite and lead to weight gain, so a doctor will likely only prescribe it on a controlled dose.

This oral tablet must only be taken once daily, typically at night, but follow the doctor’s recommendation. 

Mirtazapine might dissolve on the tongue, which means a senior doesn’t have to drink water to ingest the medication.

However, they should give it sufficient time to dissolve and cannot spit it out. 

The side effects of mirtazapine include:

  • Vomiting
  • Nausea
  • Constipation
  • Dry mouth
  • Weight gain
  • Confusion
  • Anxiety
  • Dizziness

Flu-like symptoms, seizures, fast heart rate, and chest pain are considered serious and require contacting the senior’s doctor immediately. 


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